| NPI | 1649739533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2086S0102X Surgery, Surgical Critical Care (Licence: SC DO82172) |
| Additional Taxonomies | 2086H0002X Surgery, Hospice and Palliative Medicine (Licence: SC DO82172) |
| 208600000X Surgery (Licence: SC DO82172) | |
| Enumeration Date | 2019-03-19 |
| Last Update Date | 2026-08-04 |